空腹C肽联合FIB-4指数对2型糖尿病合并非酒精性脂肪性肝病患者肝纤维化进展的评估价值

任桂晶; 韩琳; 秦少游; 王心刚; 周长玉

doi:10.3969/j.issn.1001-5256.2018.12.015

空腹C肽联合FIB-4指数对2型糖尿病合并非酒精性脂肪性肝病患者肝纤维化进展的评估价值

DOI: 10.3969/j.issn.1001-5256.2018.12.015

1. 吉林大学中日联谊医院消化内科
2. 吉林大学中日联谊医院放射科

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中图分类号: R587.1;R575.5
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出版历程
- 出版日期: 2018-12-20

Clinical significance of fasting C-peptide combined with fibrosis-4 index in assessing the progression of liver fibrosis in type 2 diabetic patients with nonalcoholic fatty liver disease

摘要

摘要: 目的利用空腹C肽联合FIB-4指数评估2型糖尿病（T2DM）合并非酒精性脂肪性肝病（NAFLD）患者肝纤维化进展状况。方法选取2016年5月-2017年7月于吉林大学中日联谊医院体检中心进行体检并诊断为T2DM合并NAFLD的患者513例,根据FibroScan测得的肝脏组织硬度值（LSM）,将患者分为非进展性肝纤维化组（466例）及进展性肝纤维化组（47例）。记录所有患者的年龄、腹围、血压、BMI、PLT计数、空腹血糖、空腹C肽、肝功能、血脂、尿酸、FIB-4指数,2组患者计量资料的比较,采用t检验或Mann-Whithey U检验,计数资料的比较采用χ2检验,用logistic回归方法筛选危险因素并构建联合诊断模型,采用受试者工作特征曲线对诊断效能进行评估。结果进展性肝纤维化组患者的年龄、AST水平、FIB-4指数、空腹C肽水平分别为51（49～55）岁、28. 9（25. 7～35. 1） U/L、0. 97（0. 75～1. 34）、（2. 64±0. 66） ng/ml,均高于非进展性肝纤维化组的50 （47～53）岁、27. 1（22. 2～32. 8） U/L、0. 85...
- 非酒精性脂肪性肝病 /
- 糖尿病,2型 /
- 肝硬化 /
- C肽
Abstract: Objective To investigate the clinical significance of fasting C-peptide combined with fibrosis-4 (FIB-4) index in assessing the progression of liver fibrosis in patients with type 2 diabetes mellitus (T2 DM) and nonalcoholic fatty liver disease (NAFLD) . Methods A total of 513 patients who underwent physical examination in Physical Examination Center of China-Japan Union Hospital of Jilin University from May 2016 to July 2017 and were diagnosed with T2 DM and NAFLD were enrolled, and according to liver stiffness measurement (LSM) obtained by FibroScan, they were divided into non-progressive liver fibrosis group with 466 patients and progressive liver fibrosis group with 47 patients. Related data were recorded, including age, abdominal circumference, blood pressure, body mass index, platelet count, fasting blood glucose, fasting C-peptide, liver function, blood lipids, uric acid, and FIB-4 index. The t-test or the Mann-Whitney U test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. Logistic regression was used to establish a joint diagnosis model. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of different indicators. Results Compared with the non-progressive liver fibrosis group, the progressive liver fibrosis group had significantly higher age [51 (49-55) years vs 50 (47-53) years, P = 0. 021], aspartate aminotransferase level [28. 9 (25. 7-35. 1) IU/L vs 27. 1 (22. 2-32. 8) IU/L, P = 0. 017], FIB-4 index [0. 97 (0. 75-1. 34) vs 0. 85 (0. 62-1. 19) , P = 0. 030], and fasting C-peptide level [2. 64 ± 0. 66 ng/ml vs 2. 33 ± 0. 79 ng/ml, P = 0. 004]. Fasting C-peptide (odds ratio [OR]= 1. 77, 95% confidence interval [CI]: 1. 201-2. 633, P = 0. 004) and FIB-4 index (OR = 2. 14, 95% CI: 1. 248-3. 613, P = 0. 004) were independent risk factors for progressive liver fibrosis in patients with T2 DM and NAFLD. Fasting C-peptide combined with FIB-4 index had an area under the ROC curve of 0. 730 (> 0. 70) in evaluating progressive liver fibrosis in patients with T2 DM and NAFLD. Conclusion Fasting C-peptide combined with FIB-4 index has a certain value in the diagnosis of progressive liver fibrosis in patients withT2 DM and NAFLD.
- fatty liver /
- diabetes mellitus, type 2 /
- liver cirrhosis /
- C-peptide

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